title: Underage drinking in the UK: changing trends, impact and interventions. A rapid evidence synthesis.
abstract: The UK is a high prevalence country for underage alcohol use. We conducted an evidence synthesis to examine (1) the changing trends in underage drinking in the UK compared to Europe and the USA, (2) the impact of underage drinking in terms of hospital admissions, (3) the association between underage drinking and violent youth offending, and (4) the evidence base for the effectiveness of alcohol harm reduction interventions aimed at children and adolescents under the age of 18 years. The following databases were searched from November 2002 until November 2012: Cochrane Database of Systematic Reviews, National Institute for Health and Clinical Excellence, The Evidence for Policy and Practice Information, DARE, Medline, The Campbell Collaboration, CINAHL, Criminal Justice Abstracts, Psych INFO and Social Care Online. Our findings revealed changes in the way children drink in the UK and how much they drink. Alcohol related harms are increasing in the UK despite overall population levels of consumption reducing in this age group. Girls aged 15-16 years report binge drinking and drunkenness more than boys. Girls are also more likely than boys to be admitted to hospital for alcohol related harm. The evidence suggests a strong association between heavy episodic binge drinking and violent youth offending. Only 7 out of 45 randomised controlled trials (RCTs) identified for this review included children and adolescents under the age of 18 years. Most were delivered in the emergency department (ED) and involved a brief intervention. All were characterised by a wide age range of participants, heterogeneous samples and high rates of refusal and attrition. The authors conclude that whilst the ED might be the best place to identify children and adolescents at risk of harm related to alcohol use it might not be the best place to deliver an intervention. Issues related to a lack of engagement with alcohol harm reduction interventions have been previously overlooked and warrant further investigation.
authors.affiliation: Institute of Psychology, Health and Society, Waterhouse Building, University of Liverpool, Liverpool L69 3GL, United Kingdom. Electronic address: chealey@liverpool.ac.uk.
authors.forename: Christine
authors.initials: C
authors.lastname: Healey
authors.affiliation: Institute of Psychology, Health and Society, Waterhouse Building, University of Liverpool, Liverpool L69 3GL, United Kingdom.
authors.forename: Atif
authors.initials: A
authors.lastname: Rahman
authors.affiliation: Mersey Care NHS Trust Addictions Clinical Business Unit, Rathbone Hospital, Mill Lane, Liverpool, United Kingdom.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Faizal
authors.affiliation: Institute of Psychology, Health and Society, Waterhouse Building, University of Liverpool, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Kinderman
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000367:Age Factors; D000428:Alcohol Drinking / Q000331:legislation & jurisprudence / Q000517:prevention & control* / Q000639:trends*; D000435:Alcoholic Intoxication / Q000453:epidemiology; D063425:Binge Drinking / Q000453:epidemiology; D016208:Databases, Factual; D005060:Europe / Q000453:epidemiology; D040261:Harm Reduction; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007604:Juvenile Delinquency / Q000639:trends; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000639:trends
keywords: Alcohol-fuelled violent offending; Children and adolescents; Evidence synthesis; Indicated interventions; Underage alcohol use